• Title/Summary/Keyword: Plantar region

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Management of the Diabetic Foot Ulcer in Elderly Patients Using the Anterolateral Thigh Perforator Free Flap (고령의 당뇨병성 족부 궤양의 전외측 대퇴 천공지 유리 피판술을 이용한 치료)

  • Kim, J-Young;Lee, In-Mook;Na, Sang-Eun
    • Journal of Korean Foot and Ankle Society
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    • v.12 no.1
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    • pp.59-65
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    • 2008
  • Purpose: To evaluate the results of anterolateral thigh perforator free flap for reconstruction of foot and ankle in old diabetic patients. Materials and Methods: Fifteen diabetic foot ulcer patients over the age of 55 were operated with anterolateral thigh perforator free flap. Hematological, hemodynamic, diabetic, bacteriologic and radiologic tests were checked with examination of blood vessel state in both the donor site and the recipient site. After surgery, serial check-up was performed at 6 week, 6 month, and 1 year postoperatively on the survival of transplantation tissue, condition of foot, and condition of walking. Results: There are one case of transplantation failure and four cases of partial tissue-necrosis. Delayed wound-healing was observed both recipient and donor tissue sites. At the final follow up, three cases of small ulcer were found at junction of flap and recipient tissue in plantar area. Fourteen out of fifteen patients could walk without any brace or walking aids. Conclusion: Reconstruction of foot and ankle region in old diabetic patients with the anterolateral thigh perforator free flap is a useful method which can prevent the amputation of foot and ankle.

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Giant Cell Tumor of Tendon sheath in the Foot (족부에 발생한 건막 거대 세포종)

  • Seo, Jin-Soo;Choo, Suk-Kyu;Chung, Hyun-Wook;Lee, Woo-Chun
    • Journal of Korean Foot and Ankle Society
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    • v.7 no.1
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    • pp.61-67
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    • 2003
  • Purpose: We evaluate the clinical, radiologic and pathologic features of giant cell tumor of tendon sheath (GCTTS) in the foot Materials and Methods: Twelve cases of GCTTS excised from foot region, at our hospital from 1999 to 2002, were analyzed. The mean duration of follow up was 19 months. The age and sex of the patient, location and size of the lesion, symptom as well as radiologic findings were evaluated. Results: The most common symptom was painless mass in 7 patients. Three patients had pain sympton and 2 patients had tenderness. The mean duration from identification of the mass to excision was 14 months. Seven cases were located in the forefoot, most commonly in the big toe with 4 cases, 2 cases in the midfoot and 3 cases in the hindfoot. The average diameter along the long axis was 2.8cm. Conclusion: GCTTS in the foot was more common in the big toe and also plantar side same as in the hand. But bony erosion and pain were more frequent than in the hand.

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Intraneural Ganglion Cyst in Foot and Ankle (족부와 족관절에서의 신경내 결절종)

  • Choi, Jang-Seok;Kim, Kwang-Hee;Kwak, Ji-Hoon;Park, Hong-Gi;Lee, Shin-Woo
    • Journal of Korean Foot and Ankle Society
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    • v.15 no.4
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    • pp.223-231
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    • 2011
  • Purpose: Pathogenesis of intraneural ganglion is controversial, however, the synovial theory that the intraarticular region is the origination of disease has come into the spotlight nowadays. But there are a few researches about intraneural ganglion in foot and ankle. We studied 7cases of intraneural ganglion. We are going to prove the synovial theory by indentifying articular branch of intraneural ganglion. Materials and Methods: From August 2003 to May 2011, we evaluated 7 ouf of 8 patients diagnosed as a intraneural ganglion in foot and ankle. The gender ratio were 4 male and 3 female, and the mean age at the time of surgery was 52.9 years. Clinically, we checked pre and post operative symptom, muscle tone and whether loss of muscle tone and sensation exists. We analyzed surgical records and preoperative MRI and compared those with intra-operative finding. Results: In MRI analysis of 7cases, the connection around the joints were confirmed, and 1 case was confirmed in the retrospective analysis of MRI. Intraneural ganglions occurred in medial plantar nerve 3 cases, lateral plantar nerve 1 case, superficial peroneal nerve 1 case and sural nerve 1 case. We could not found recurrence during the follow up periods. Most patients relieved pain after operation, but recovery of sensation was unsatisfactory. We could find some cases pathological finding of the nerve intraoperatively, and clinical result of that cases was poor. Conclusion: Intraneural ganglion can occur in various parts in foot and ankle. We concluded that the intranneural ganglion originated from joint by identifying the artichlar branch of ganglion. Due to its small size, it is difficult to find articular branch in operation field. But we do our best to find and remove articular branch. Currently, considering the small amount of research in foot and ankle, more research about articular brach is needed.

Effects of Hetero-segmental Electro-acupuncture on Formalin Induced Pain in the Rat (거자법(巨刺法)에 의한 전침자극(電鍼刺戟)이 흰쥐의 formalin 유도(誘導) 통증(痛症)에 미치는 영향(影響))

  • Park, Sang-Kyun;Kim, Jae-Hyo;Kim, Min-Sun;Park, Byung-Rim;Sohn, In-Chul;Kim, Kyung-Sik
    • Journal of Acupuncture Research
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    • v.17 no.2
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    • pp.231-246
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    • 2000
  • Acupuncture has been used for treatment of numerous diseases, especially for pain control in the oriental culture. However, the mechanism of pain control by acupuncture was not clear so far. The present study was examined that the effects of electro-acupuncture (EA) applied to the acu-point of extra-segmental area on modulation of formalin induced pain in Sprague - Dawley rats. In order to apply EA to acu-points in the plantar area of right fore paws, a pair of teflon - coated stainless steel wires were implanted in HT 7 (shin-mun) and PC 7 (dae-neong) 5 days before behavioral test. A behavioral test was performed by means of video camera after injection of 5% formalin ($50{\mu}l$) into the lateral plantar region of left hind paw. EA was delivered by a constant current stimulator at 4~5 mA, 2 ms, and 10 Hz for 30 min. The electromyographic activities were recorded in the biceps femoris muscle under chloral hydrate anesthesia. Test stimuli with 1~9mA were applied to the sural nerve territory including the medial portion of the 4th toe and the lateral portion of the 5th toe. Behavioral responses including favoring, flinching and bitting were occured in the biphasic pattern, such as the lst phase (0~5 min) and the 2nd phase (20~45 min) after formalin injection. However, EA (4~5 mA, 2 ms, 10 Hz) significantly inhibited Che behavioral responses. EMG activities of flexor reflex had a latency of 100~300 ms and thresholds of test stimuli for EMG were 4~5 mA in normal rats. Injection of formalin decreased threshold of test stimuli and increased EMG activities for 2hrs after injection. However, EA significantly inhibited EMG activities of flexor reflex increased by formalin and recovered EMG evoked thresholds. These results suggest that contralateral extra-segmental EA inhibits the first and second phases of formalin induced pain but their mechanism be needed to examine additionally.

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The Study on critical Value of Kinematical Evaluation Variables of Lower Extremity Pronation in Biomechanical Evaluation of Running Shoes (운동화의 생체역학적 평가시 하지 회내운동의 운동학적 평가변인에 대한 상해 기준치 연구)

  • Kwak, Chang-Soo;Jeon, Min-Ju;Kwon, Oh-Bok
    • Korean Journal of Applied Biomechanics
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    • v.16 no.4
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    • pp.175-187
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    • 2006
  • The purpose of this study was to find the relationship between Achilles tendon angle, angular velocity from 2D cinematography utilized to easily analyze the functions of shoes, ankle joint moment, knee joint moment, and hip joint moment from 3D cinematography utilized to predict the injury. Also, this study was to provide the optimal standard to analyze the injury related to the shoes. Subjects in this study were 30 university male students and 18 conditions (2 types of running speed, 3 of midsole hardness, 3 of midsole height) were measured using cinematography and force platform. The results were as following. 1) Hip joint abduction moment was effected by many variables such as running speed, midsole height, maximum achilles tendon angle, ground reaction force. 2) Knee joint rotational moment in running was approximately 1/10 - 1/4 times of the injury critical value and eversion moment was approximately 1/4 - 1/2 times of the injury critical value. 3) Ankle joint pronation moment in running was 1/3 - 1/2 times of the injury critical value. 4) Knee joint rotational moment was found to be irrelevant with maximum achilles tendon angle or angular velocity. 5) Pronation from running was thought to be relevant to rather eversion moment activity than rotational moment activity of knee joint. 6) Plantar flexion abductor of ankle showed significant relationship with the ground reaction force variable. 7) When the loading rate for ground reaction force in passive region increased, extensor tended to be exposed to the injury. Main variables in biomechanical analysis of shoes were impact absorption and pronation. Among these variables, pronation factor was reported to be relevant with knee injury from long duration exercise. Achilles tendon angle factor was utilized frequently to evaluate this. However, as the results of this study showed, the relationship between these variables and injury relating variable of knee moment was so important. Studies without consideration on this finding should be reconsidered and reconfirmed.

Factor Analysis of the Somatosensory for Foot according to the Instability Level of Snatch Lifting (역도 인상동작 불안정성 수준에 따른 발바닥 체성감각요인 분석)

  • Moon, Young Jin
    • Korean Journal of Applied Biomechanics
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    • v.30 no.1
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    • pp.7-16
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    • 2020
  • Objective: It is to find factors related to stability through analysis of plantar pressure factors according to the level of instability when performing Snatch. Method: Foot pressure analysis was performed while 10 weightlifters performed 80% of the highest level of Snatch, and motion was classified and analyzed in 3 grades according to the level of instability. Results: First, in Bad Motion, the movement distance of the pressure center in the direction of ML and AP was larger significantly in Phase 2. Second, in Phase 2, the number of zero-crossing in the AP direction was larger statistically significantly in Good Motion. Third, in the bad motion in Phase 3, the number of zero-crossing in the ML direction showed a significantly larger value. Fourth, in Phase 4, it was found that the more stable the lock out motion, the greater the activity of foot controlling in the left and right directions. Fifth, Phase 3, the greater the Maximum/Mean foot pressure value, the more stable the pulling action. Sixth, in Phase 2, the foot pressure was concentrated with a wide distribution in the midfoot and rearfoot. Seventh, the triggering number of the forefoot region was small in the last pull phase. Eighth, the number of triggers in the toe area was significantly higher during Good Motion in Phase 4. Conclusion: Summarizing the factors of instability in Snatch, there was no significant difference in Phase 1 for each condition. In order to enhance the stability in Phase 2, the sensory control ability in the AP direction is required, and focusing the foot pressing motion with a wide distribution in the middle and rear parts increases the instability. In Phase 3, it was found that the more unstable, the more sensory control activity was performed in the ML direction, the stronger the forefoot pressing action should be performed for a stable Snatch. In Phase 4, It is important that the feet sensory control activity in ML directions and the control ability of the toes in order to have stable Lock out motion.

Nevoid Basal Cell Carcinoma Syndrome : A Case Report (기저세포모반증후군 : 증례 보고)

  • Lee, Yoonjung;Park, Jaehong;Choi, Sungchul;Lee, Sooeon;Kim, Kwangchul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.41 no.1
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    • pp.34-39
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    • 2014
  • Nevoid basal cell carcinoma syndrome(NBCCS) is a autosomal dominant disorder, and its major manifestations are multiple basal cell carcinoma, keratocystic odontogenic tumor, rib anomalies, palmer and plantar pits, calcification of the falx cerebri. Keratocystic odontogenic tumor(KCOT) is defined as intraosseous tumor of odontogenic origin with a characteristic lining of parakeratinized stratified squamous epithelium and potential aggressive behavior. We report a case of a 3-year-old patient with nevoid basal cell carcinoma syndrome who initially presented with unilocular keratocystic odontogenic tumor in maxillary canine region. Keratocystic odontogenic tumor was treated by enucleation, and periodic follow-up check will be required for early diagnosis of additional diseases related with this syndrome.